Yoga Injuries: Sleeping/Half Pigeon Part I: The Anatomy

Hey everyone! This article marks the start of a 3 part series I’ll be doing on yoga injuries, specifically pertaining to our favorite, Sleeping/Half Pigeon pose. So get your candles out and prepare to light them in remembrance, as this series is going to be a tough one to swallow. Half Pigeon, or Sleeping Pigeon, is dangerous as it may be damaging the cartilage in your hip.

Let’s talk about everyone’s favorite pose Half Pigeon, “Sleeping Pigeon,” or for my fancy Sanskritters Eka Pada Rajakapotasana. It’s the staple of just about every yoga class. (If you haven’t done this pose yet, what kind of cave were you doing yoga in?)

“Sleeping Pigeon” or Half Pigeon

It carries with it the wonderful feelings of stretching your butt paired with relaxation, and is usually used towards the end of class in a more restorative/relaxing setting. Often times it signifies the transition between the “I’m going to die this is really hard” active part of class into the sigh-of-relief relaxing part of class. I’d wager to say if you asked any Yogi what their top 3 favorite yoga poses are 9 times out of 10 Half Pigeon will be there. It’s a HUGE pose in our yoga community! (More on this in Part II)

And there’s were the trouble lies, this pose may in fact be pretty dangerous for your hip-joint. A bold claim I know, but before you grab your torch and pitchfork and try to burn me down, keep reading and get the cold hard science to form your own opinion on this matter.

We’ll talk in this post about hip injuries and the anatomy behind how this pose can cause injury. The next post will be on the history of Sleeping Pigeon, its impact and intention in our community, plus safe alternatives. Then we’ll wrap it up in part 3 with what to do with all this information, for both yogis and yoga teachers.

My intention: I’m here to present some facts, as unbiased as possible, and allow you an opportunity to form an opinion on the matter. After all, it is ultimately YOU who decides whether or not to take a Sleeping Pigeon in your next class.

So…

We’ve got a lot to cover in Part 1 and it’s going to be a doozy

Before we continue: for the sake of consistency throughout the article I will now refer to Pigeon pose and all of its pseudonyms as Sleeping Pigeon.

Let’s start where this all began for me. Back in 2013 an article was posted in the New York Times Women’s Flexibility Is a Liability (in Yoga) by William J. Broad. Check it out if you haven’t yet, it’s a great read and it’s very informative. Yoga injuries is not something widely discussed in the yoga world, many believe that they can’t get injured in yoga, but in truth you can get injured doing damn well anything (even getting out of bed).

For my readers too lazy to click the above link:

Broad details the growing incidences of hip arthritis in female yoga practitioners. Their arthritis getting so bad that women in the ages of 30-40 are getting total hip replacements and surgeries. It’s surmised that it’s the extremes that we place the hips in yoga that repeatedly slam the femoral head against the acetabulum (fancy anatomy talk for your thigh bone smacks into your hip socket) which results in arthritis (-itis = inflammation, arth- = joint).

In case you forgot what that all looked like

How prominent is this?

An orthopedic surgeon, in the article, was seeing up to 10 yogis a month or about 100 a year.

Reality check: that’s just 1 surgeon in Atlanta, now imagine how many hip surgeons there are in just Atlanta and assume they’re seeing roughly the same. Damn. Now expand your view and multiply that by every major city in the US…

Oh F*ck, that’s a lot of potentially damaged hips!

The last time I did a basic anatomy lecture I presented this article as a way to talk about safety and also increase awareness of hip trauma in a yoga classroom. After calming the looks of terror on everyone’s faces, I got this question:

“Garrett, what poses place extremes on the hips that I should be looking out for?”

At the time, I had no idea. Twas’ a great question, but in order to accurately answer it we have to start getting technical.

Active vs Passive Postures

The next breadcrumb along this path requires we start breaking down some anatomy. After the aforementioned question I started doing some research, but I really wasn’t able to answer it until I had the honor of attending Jules Mitchell’s Yoga & Biomechanics Webinar shortly after my lecture. I learned so much there, and a lot of what I’m about to detail has its origins from what she taught in her “Pigeon with a Purpose” section in Day 2 of the webinar.

In order to accurately describe what poses place the hips into extremes we have to break down two terms. Active & Passive Range of Motion (AROM & PROM).

AROM = when you move your own body into a position

PROM = when an outside force (a person, or even you) movesyour body beyond the position you reached in AROM

In the context of yoga, AROM vs PROM would be best described by Tree Pose:

In Tree we often grab our foot and place it closer to the groin:

If you were to just lift your leg and plant it on your thigh, wherever it lands without touching it, is your hip AROM.

When you grab your foot and place it higher on your thigh, that’s hip PROM.

In AROM: our muscles are active and engaged, which is usually safer for joints because the muscles and your nervous system (idealistically) regulate just how far you go.

In PROM: you move past both the muscles and joints and put more force on the joints. That’s why you’ll only really see PROM with most manual therapists (PT’s, Chiropractors, etc).

Important take home: Your nervous system and muscles work together at joints to limit motion that is potentially dangerous. Your muscles serve as brakes for unwanted motion. In AROM the brakes are active and limit your motion, in PROM we turn off the brakes which allows for that increase in movement.

Side bar: it is possible to muscle through AROM and damage a joint, Broad’s article above describes how Men are prone to “pushing through” postures and damaging joints by over-activating their muscles, despite their nervous system attempting to hit the brakes.

Back to our question: What poses place the hips into extremes?

Better question: What poses DISENGAGE the muscles of our hips and allow it to go into extremes?

I’ll give you a hit: it rhymes with Peeping Shmigeon

So just how does this happen? Let’s look at some more science on hip stability!

You Are Now Entering: The Deep Butt

What you may not have learned from watching twerking videos, is that your butt has several layers of muscles. The outermost, or Superficial, Butt being your Glute Max. Next up are the Glute Medius and Glute Minimus in the “Middle Butt.” and even further down deep towards your pelvis, sacrum, and hip socket lies 6 very important muscles that live in the “Deep Butt.”

These 6 little muscles are known as the Rotator Cuff of the Hip, or as I like to jokingly call it, the Butt-tater Cuff. I’ll wager to say you’ve heard about the Rotator Cuff of the Shoulder, but if I start spouting out the names of these 6 external rotators of your hip you’ll have maybe heard of one of them, the piriformis.

No they are not Harry Potter spells, they’re real life muscles that are very important for the mobility and stability of your hip.

Now unfortunately, I don’t have a definitive concrete source for this next bit. It’s the conclusion reached through the connection of the of points above, paired with a feeling I hope to help you experience in your own body.

Here it goes: When you fold forward in Pigeon and move into the Passive Sleeping Pigeon the Butt-tator Cuff muscles shut off.One can conclude, given the facts above, that this now DESTABILIZES your hip and allows your femoral head to slam into your acetabulum. Which over time, results in inflammation of the cartilage of the hip (aka arthritis) Ouch!

The good part: As you fold forward the weight of your torso dumps into your front destabilized hip.

The best part: we then hold this destabilized torso-weight-dumped position for, on average, 30 seconds a side per class.

The bestest part: we LOVE to do and get deepening assists in this pose, especially at the hips by pressing down and increasing the rotation of the thighs.

If you’re not doing this right now, please go back and reread the above section.

WHAT – THE – FUDGEASANA are we doing?! It’s no wonder people are going in for hip surgeries at the ripe old age of 30.

Let me break it down for you without the anatomy word dogma:

As we fold into Sleeping Pigeon, we shut off the brakes of our hip (the muscles that are supposed to keep it safe), then we relax which gives a momentary feeling of “feel good stretching” whilst the weight of our torso allows the top of our thigh bone to slam into the cartilage of the hip socket. In the long term, this repeated slamming wears down the shock absorbing cartilage of the hip-joint resulting in nasty hip pain and even a dreaded trip to the hip surgeon.

If you need a break right now, please get up, unplug, walk around, and take a moment to process this. I know it took me about 10 minutes of staring at the wall repeatedly doing the actions of the above .gif until I was able to return to being a functional human.

Now that you’re back I promised you a feel (and not the pit of despair that’s currently growing in your stomach).

Since I don’t have a strong source, your body is now my source

and it’s about to feel pretty good

How to engage & feel your Deep Butt:

Tree pose: Super simple. Stand on one leg. Lift your other leg and pant your foot as high as you can, without actually touching your leg, or hiking your hip. You should feel that right there in your butt on the floating leg, or possibly in the front of your groin (if that area needs some stretching). By the way it’s OKAY if your plant your foot on your knee (so long as there’s no pain or discomfort).

Active (Backbend) Pigeon:

Pop into Pigeon as you usually would.

From Downdog lift one of your legs. Now plant it in front of you and however it lands, leave it, try not to take it any further than how you naturally land (obviously adjust for comfort and safety).

Walk your hands to your hips and stay upright.

Drive your front shin (your figure 4 leg) into the mat and lift up out of your pelvis (hips lift off the ground). You should be feeling in both your front leg and especially back leg butt now. Want more? Extend your hands to the sky and see just how strong your back truly is.

Pretty nuts right? Now that is a Tree & Pigeon pose! If you didn’t quite feel that, that’s what messages are for, shoot me one! Or stay tuned, there’s more in store that may help you!

So with all this new information, what are we do to about Sleeping Pigeon?

Pretty much

One of my fellow Yoga teachers, Raquel, said that after learning this, she went home and lit a candle for all the feels and stretches Sleeping Pigeon gave her. Me, I got kinda mad, and borderline depressed. I took a vow to do no harm as a Doctor, and now here I am potentially harming everyone whose taken my class in the last 2 years. I’ll let you deal with it however you deem appropriate. Try not to get too drunk on kombucha though, there’s more in store.

Coming up in Part II: How did this unstable version of Pigeon become so prominent in our yoga community? & Safe alternatives to Sleeping Pigeon.

Questions/feedback? Shoot me a message! If this stuff resonated with you please share it, it can truly save a fellow yogi from a nasty hip injury! That’s the purpose of this article and series, #getwokenotbroke

I haven’t really thought of that before, that’s a really good question! Off the top of my head, I think the answer lies in how far apart the legs are and how low the torso is to the mat. If you look at traditional child’s pose, the knees are together, therefore the femur and the hip socket are receiving nominal loads from the torso because they are more or less resting on each other. Now when the legs widen one could hypothesize that the same thing occurs in sleeping pigeon, where the weight of the torso potentially jams the femoral head into the acetabulum. It’s important to note though, that the amount of external rotation of the hip in child’s pose is way less than that of pigeon. I’m going to look more into this and potentially cover it in the near future when I talk about another, less common pose, that jams the femoral head into the acetabulum. Thank you for such an amazing question!

If someone has hip destabilization issues already, Child’s pose places the thighs against the abdomen which puts pressure on the acetabulum and as well as stretching the ligaments that connect the pelvis to the upper femur. The spine is also compromised because Childs creates spinal flexion or the C shape where the lumbar curve is reversed and the ligaments in the SI joints get stretched. There is not abundant sensory nerves in the ligament tissue so damage can be happening without any pain to signal yogis to back off. Most certainly just like in sleeping pigeon, ligament laxity is created when the spine is in flexion for long holds in child’s pose. If a practitioner has osteoporosis or osteopenia, child’s pose could cause compression fractures of the vertebral bodies. I gave up this pose over 20 years ago as many people felt knee pain as well. There is a version with the knees apart and the arms active, chest lifted and spine in neutral curves that I sometimes teach in YogAlign.

Dr. Gare, thank you for this article as I am sure that yoga injuries are much more prevalent than is reported since yoga is unregulated. It is alarming that people do not realize that poses like sleeping pigeon can create damage to the hip joint as well as ligament laxity in the pelvic girdle including those deep six muscles. It can be difficult for yogis to hear what you are saying but the fact is that we need more science and more anatomical common sense in modern day yoga practice if we are to remain credible. Too many people are getting injured even famous teachers are receiving hip replacements so it is long overdue and the fact is that yoga needs an anatomical wake up call. My name is Michaelle Edwards and I created a method of yoga called YogAlign which is designed to align posture using movements and body positions related to real life functional movement. I long ago eliminated any poses like sleeping pigeon, hip openers,plow, hero, and straight leg forward bends. Too many women were coming to me with yoga injuries and so I contacted William Broad after reading the NY Times article he wrote about men’s yoga injuries being prevalent. I explained that the compression of the acetabulum in many yoga poses requiring forward bending was causing cumulative damage to women’s hips who do yoga. At the time Broad did not realize that women’s hips were such an issue but then he investigated and the orthopedic surgeons confirmed it and he wrote the NY times piece you mentioned He also linked my article “When Flexibility becomes a Liability” to the NY times. I am conducting a survey on yoga injuries and over 500 people injured from yoga have taken it. I plan to share the information soon if you are interested, I can share. If anyone wants to take it, please go to http://www.yogainjuries.com

Hello Michaelle! It’s a true honor to have you read my post, I’m a huge fan of your work and what you teach at YogAlign (I just received your book for Xmas and was looking forward to reading it once I completed Adam Wolf’s Real Movement). A few of the poses you listed above I no longer teach, or provide different modifications and it’s good to hear that there are yogis out there staying present with modern anatomy and doing what they can to help. Thank you for all that you do!

Thank you for the article. These are issues Ive been studying and teaching for over 20 years. The problems with passive vs. active postures. The inherent problems and subsequent damage due to external rotation of the hip joint. So many teachers and schools continue to teach external rotation of the BACK leg in standing poses! Their femurs and psoas are JACKED by the time they get to pigeon (I call it “lazy pigeon ” and I don’t teach it EVER as a passive pose). Usually the student is gassed by that time in class anyway and even if the teacher were to (correctly) teach it as an active pose, most students don’t have the energy to engage.
And by the way, Ekapadarajakapotasana (1,2,3and 4) ARE BACKBENDS!!!! Why are teachers teaching it as a lazy, passive forward bend?

Simply put, there are way too many poorly trained teachers out there. We can discuss why in length but that would be a whole book!

Oh I very much agree on all counts Anthony. It’s really sad but not a lot of teacher actually know the anatomy behind what they are teaching. It’s not their fault too, a lot of yoga anatomy lectures in 200 hour programs are pretty sub par. You memorize a bunch of stuff, then never use it practically when you teach pffft.

That’s why I always encourage teachers to reach out and expand their knowledge base. You need to do your homework, the training is just a foundation! Too many people forget about svadhyaya though 😦